This factsheet is for people who have laryngeal (larynx) cancer, or who would like information about it.

Laryngeal cancer is cancer of the larynx. The larynx is a 5cm long tube that separates the oesophagus (the pipe that goes from the mouth to the stomach) from the windpipe (trachea). Laryngeal cancer is much more common in men – for every women diagnosed, four men are diagnosed.

About laryngeal cancer
Symptoms of laryngeal cancer
Causes of laryngeal cancer
Diagnosis of laryngeal cancer
Treatment of laryngeal cancer
Help and support

About laryngeal cancer

Your larynx is found in the front of your neck at the level of the ‘Adam’s apple’, which is often much easier to notice in men than it is in women. It is an air passage that extends from your tongue to your trachea and produces the sounds you make when you speak. It also stops food entering your trachea and allows you to breathe.

Laryngeal tumours develop when cells in your larynx grow in an abnormal and uncontrolled way. Malignant (cancerous) tumours can grow in your larynx and spread (metastasise) to other organs through your bloodstream or lymphatic system (part of your immune system). Benign (non-cancerous) tumours don't spread to other parts of your body.

About 1,800 men and 400 women develop laryngeal cancer in the UK every year. Older people (over 50) are more likely to develop laryngeal cancer than younger people.

Types of laryngeal cancer

There are several different types of laryngeal cancer. Squamous cell cancer, which starts in the cells lining your larynx, is the most common and causes more than 9 out of 10 laryngeal cancers. Another less common type is adenocarcinoma, which starts in your gland cells. These cells, also known as adenomatous cells, are scattered around the surface of your larynx and produce mucus. Sarcomas are a much rarer type of malignant tumour. They start in connective tissues such as cartilage, muscle and nerves.

Symptoms of laryngeal cancer

One of the most common symptoms of laryngeal cancer is a hoarse voice, or change in voice pitch. Hoarseness is a common symptom of conditions other than cancer, such as viral laryngitis (sore throat), or an allergy. However, if you have a hoarse voice for longer than four weeks, see your doctor. Other symptoms of laryngeal cancer include:

  • pain or discomfort when you swallow – this can vary from feeling like there is a crumb stuck in your throat to being completely unable to swallow
  • a lump in your neck or throat
  • unexplained coughing
  • restrictive and noisy breathing
  • unexplained weight loss
  • earache that doesn’t go away

All of these symptoms can also be caused by conditions other than laryngeal cancer. If you have any of these symptoms, see your doctor to confirm a diagnosis.

Causes of laryngeal cancer

There is no single cause of laryngeal cancer, but there are certain factors that may increase your risk of developing it, as follows:

  • Smoking tobacco. If you smoke regularly, you are at a higher than average risk because you inhale chemicals that cause cancer.
  • Drinking alcohol excessively. If you drink heavily – particularly spirits – you are three times more likely to develop laryngeal cancer than non-drinkers.
  • Having the human papilloma virus (HPV). If you develop papilloma growths on your larynx you may have an increased risk of developing laryngeal cancer later in life.
  • Poor diet. If your diet lacks essential vitamins and minerals, this may increase your risk. A diet high in fresh fruit and vegetables and low in fat may help reduce your risk.
  • Environmental factors, including exposure to chemicals such as asbestos, formaldehyde, nickel and sulphuric acid. Being regularly exposed to lots of wood dust, paint fumes and soot or coal dust for a long time may increase your risk.

Diagnosis of laryngeal cancer

Your doctor will examine your throat and ask about your symptoms. You may be referred to a doctor who specialises in ENT (ear, nose and throat) conditions. He or she may ask you to have the following tests to confirm a diagnosis:

  • An indirect laryngoscopy. This involves putting a small mirror – like the one your dentist uses when checking your teeth – into your mouth to look at the back of your throat and your larynx.
  • A nasoendoscopy. Your doctor will pass a narrow, flexible, tube-like telescopic camera, known as an endoscope, into your nose and down the back of your throat to see your larynx. The procedure may feel a bit uncomfortable, so your doctor may use a local anaesthetic spray.
  • A biopsy. This is when a small sample of tissue is removed. Biopsies of the larynx are usually carried out under general anaesthesia, so you may need to stay in hospital overnight. Your tissue sample will be sent to a laboratory for testing and will usually come back within a week.

If your specialist has confirmed a diagnosis of laryngeal cancer, you may need further tests to find out the extent of your primary tumour and check whether the cancer has spread to other parts of your body. These tests may include a combination of CT (computerised tomography) and MRI (magnetic resonance imaging) scans, which use X-rays or radiowaves to produce two- and three-dimensional pictures of the inside of your body. You may also have blood tests and an X-ray of your chest.

Treatment or laryngeal cancer

Your treatment will depend on the type, stage and grade of your laryngeal cancer. It will also depend on your age and general health.

Radiotherapy

Radiotherapy is the most common treatment for people who have small laryngeal tumours that haven’t spread. The aim of the treatment is to destroy the cancer cells in your larynx and surrounding lymph nodes.
If you have a large laryngeal tumour, you may need to have radiotherapy as well as surgery. Radiotherapy may be used either to shrink your tumour (to make it easier to remove), or to kill any cancerous cells that might not have been removed during surgery.

Chemotherapy

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If you have a large laryngeal tumour, you may be given chemotherapy before, or at the same time as, radiotherapy treatment. You may be injected with a chemotherapy medicine, via a drip in your arm.

Surgery

If you have a very small or early stage laryngeal tumour, you may be able to have laser surgery to remove it. Your surgeon will use a narrow, intense beam of light to cut out the abnormal cancer cells – sparing as much of your larynx as possible.

If you have a large or advanced stage laryngeal tumour, you may need open surgery to remove part (partial laryngectomy) or all (total laryngectomy) of your larynx. Your surgeon may also need to remove some of your lymph nodes nearby. In a total laryngectomy, your surgeon separates your windpipe from your larynx, and joins it to an opening (stoma) in your neck.

After a partial laryngectomy your voice will be weaker, or more hoarse than it was before. You may need to have a tube called a tracheostomy inserted through the front of your neck to help you breathe. This is usually only temporary, until your larynx has healed.

If you have a total laryngectomy, it will affect the way you breathe, speak and swallow. You will breathe through your stoma and won’t be able to speak like you used to. You may be able to have a voice prosthesis fitted, or use a battery-operated machine called an electropharynx. Alternatively, you may be able to learn to produce a voice by using your oesophagus. Your doctor or nurse will be able to advise you, or may refer you to a speech and language therapist for further advice.

Biological therapy

If you have squamous cell laryngeal cancer and your tumour hasn’t spread, your surgeon may treat you with a biological therapy, in combination with radiotherapy. Biological therapies, including monoclonal antibody treatments like cetuximab, use substances which are naturally produced in your body to destroy cancer cells.

Help and support

Being diagnosed with cancer can be distressing for you and your family. Specialist cancer doctors and nurses are experts in providing the care and support you need. There may also be support groups so you can meet people who’ve have similar experiences to you. Ask your doctor for advice.

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.
Will I be able to eat and drink normally after I’ve had treatment on my larynx?
Will I be able to speak normally again if my larynx is removed?
How would I breathe if I have a laryngectomy?

Will I be able to eat and drink normally after I’ve had treatment on my larynx?

Answer

It depends on the type of treatment you’ve had, but in general you will probably find treatment for laryngeal cancer is more likely to affect the way you breathe and speak than the way you eat and drink. You may find you have difficulty swallowing at first, but this should improve as you recover.

Explanation

Your larynx is part of your trachea (windpipe), not your oesophagus (the pipe that goes from your mouth to your stomach), so having treatment for laryngeal cancer is more likely to affect the way you breathe and speak than the way you eat and drink. However, different treatments can affect how you eat and drink in different ways.

It can be hard to swallow food after radiotherapy treatment as you’re likely to have a dry mouth and sore throat. Eating softer foods can help. Surgery will also make swallowing difficult, but this will get easier as you recover. Generally, laser surgery doesn't make eating uncomfortable afterwards.

Rarely – after some types of open surgery – you may not be able to swallow at all. If you can’t swallow, you will need to have a tube passed into your stomach (gastroscopy) to feed you.

After a laryngectomy, you may find your sense of smell is poorer than it was before. This has a direct effect on your sense of taste. You will probably choose to eat more strongly flavoured foods as things can seem to have less taste to you than they did before. Try adding sauces, garlic, lemon juice or herbs and spices to your meal to make it more flavoursome. After a few months, however, you may find your sense of smell and taste goes back to how it was before your treatment.

Further information
      

Cancer Research UK
0808 800 4040
www.cancerhelp.org.uk
Macmillan Cancer Support
0808 808 0000
www.macmillan.org.uk

Sources

Will I be able to speak normally again if my larynx is removed?

Answer

After a laryngectomy, you won’t be able to speak in the normal way. However, most people can learn how to make sounds and speak using a variety of different methods.

Explanation

If you need to have your larynx removed, a speech and language therapist will help you find the best ways to communicate.

About two-thirds of people who have a laryngectomy are able to use a voice prosthesis or speak with their oesophagus (the pipe that goes from your mouth to your stomach). This very much depends, however, on the type of surgery you’ve had and what you prefer.

After your surgeon has removed your larynx, he or she may fit a valve onto the opening made in your neck. This is called a voice prosthesis. Pressing on the prosthesis with your thumb or finger when you breathe out will cause your oesophagus to vibrate and make a sound. Your lip, tongue and cheeks also help to make sounds.

Oesophageal speech uses the vibrations of your oesophagus to create sounds, along with the shape of your lip, tongue and cheeks. An electronic device (electropharynx) can also help you develop your voice.
You may prefer to use forms of writing to communicate.

There may be support groups you can join so you can meet people who have had similar experiences to you. If you have any questions or need more information, ask your doctor for advice.

Further information

Macmillan Cancer Support
0808 808 0000
www.macmillan.org.uk

Sources

  • Cancer of the larynx. Macmillan Cancer Support. www.macmillan.org.uk, published 2008
  • Larynx or laryngeal cancer (cancer of the voice box). Cancer Research UK. www.cancerhelp.org.uk, accessed 3 March 2010

How would I breathe if I have a laryngectomy?

Answer

If you have a laryngectomy, your surgeon will bring your windpipe (trachea) to the surface of your skin through a hole, called a stoma, in your neck. You will no longer breathe through your mouth, but instead through the stoma.

Explanation

There are two tubes in your neck – your oesophagus (the pipe that goes from your mouth to your stomach) and your trachea. After a laryngectomy, your oesophagus will remain intact and work very much like it did before. Your trachea, however, will be separated from your larynx and will no longer link up to your mouth. Instead of taking air in through your mouth, it will pass directly into your lungs from the stoma in your neck.

You may need to use a stoma cover when you shower and special equipment if you go swimming to prevent water getting into your lungs. You may also need to use a stoma filter to protect against dust and dirt, or a heat and moisture exchanger (HME) which warms and moistens the air to prevent coughing.

Having a laryngectomy can be distressing. Specialist doctors, nurses and speech therapists are experts in providing the care and support you need. You may be able to join a support group so you can meet and share experiences with other people who have had a laryngectomy.

Further information

Cancer Research UK
0808 800 4040
www.cancerhelp.org.uk
Macmillan Cancer Support
0808 808 0000
www.macmillan.org.uk

Sources

  • Cancer of the larynx. Macmillan Cancer Support. www.macmillan.org.uk, published 2008
  • Larynx or laryngeal cancer (cancer of the voice box). Cancer Research UK. www.cancerhelp.org.uk, accessed 3 March 2010

Related topics

Cancer – an overview
Cancer staging and grading
Chemotherapy
CT scan
Mouth cancer
MRI scan
Radiotherapy
X-ray
 
This information was published by Bupa’s Health Information Team and is based upon reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
 
Publication date: June 2010.
 

Laryngeal cancer factsheet

Visit the laryngeal cancer factsheet for more information.

Related topics

Cancer – an overview
Cancer staging and grading
Chemotherapy
CT scan
Mouth cancer
MRI scan
Radiotherapy
X-ray

Further information

Macmillan Cancer Support
0808 808 0000
www.macmillan.org.uk

Sources

  • Larynx or laryngeal cancer (cancer of the voice box). Cancer Research UK. www.cancerhelp.org.uk, accessed 3 March 2010
  • Standring S. Gray's anatomy. 40th ed. Churchill Livingstone Elsevier, 2008:577
  • Cancer of the larynx. Macmillan Cancer Support. www.macmillan.org.uk, published 2008
  • Cassidy J, Bissett D, Spence R, et al. Oxford handbook of oncology. 2nd ed. 2006:403–34
  • Laryngeal cancer. Merck Online Medical Library. www.merck.com/mmhe, published 2008
  • Improving outcomes in head and neck cancers. National Institute for Health and Clinical Excellence (NICE). www.guidance.nice.org.uk, published 2004
  • Head and neck cancer – cetuximab: guidance. National Institute for Health and Clinical Excellence (NICE). www.guidance.nice.org.uk, published 19 September 2008

 
This information was published by Bupa’s Health Information Team and is based upon reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice form a qualified health professional.
 
Publication date: June 2010.

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